J Korean Med Assoc.  2009 Sep;52(9):856-864. 10.5124/jkma.2009.52.9.856.

The Withdrawal of Life-sustaining Management for Dying Patients: A Study in Judicial Precedents Worldwide

• Kim JH

• KMID: 1936489
• DOI: http://doi.org/10.5124/jkma.2009.52.9.856

Abstract

The decision to withdrawal of life-sustaining management for dying patients is one of the most difficult challenges in modern medical ethics. Due to the advances in medical science and technology, terminally ill patients can survive longer than ever expected before. More specifically, artificial ventilation, nutrition, and recently developed drugs constitute the cores of life -sustaining management for dying patients. The issues of patients' autonomy, medical paternalism and sanctity of life are related with this particular problem. Korean Supreme Court recently approved the request of a permanent vegetative status patients' family to terminate the artificial ventilation and allow the patient to die. Korean Medical Association is currently seeking to establish the guideline. Korean government and parliament are also looking for a way to enact the law. However, religious sector including Catholic Church and a significant proportion of the population have opposed the legalization of euthanasia. A careful study in other countries' legislations related to the care for dying patients would help to establish the consensus in the nation.

Keyword

Advance directives; Death with dignity; End-of-life care; Euthanasia; Terminal Patients

MeSH Terms

Advance Directives
Consensus
Ethics, Medical
Euthanasia
Humans
Jurisprudence
Paternalism
Right to Die
Terminally Ill
Value of Life
Ventilation

Reference

1. Kutner L. Due process of euthanasia: the living will, a proposal. Indiana Law Review. 1969. 44:539–554. Cristiano Vezzoni. Advance Treatment Directives and Autonomy For Imcompetent Patients: an international comparative survey of la and practice, with special attention to the Netherlands. New York: The Edwin Mellen Press, 2008: 3-4.

2. Lee DI. Reflections on the Ethics of Withdrawing LIfe-prolonging Medical Treatment: The Decision of the Seoul Westrern District Court. Korean J Med Ethics. 2009. 12:43–60.

3. http://article.joins.com/article/article.asp?total_id=3487368&cloc=rss|news|total_list. Accessed at 26.July 2009.

4. Fischer S, Huber CA, Furter M, Imhof L, Mahrer Imhof R, Schwarzenegger C, Ziegler SJ, Bosshard G. Reasons why people in Switzerland seek assisted suicide: the view of patients and physicians. Swiss Med Wkly. 2009. 139:333–338.

5. Michalsen Andrej. Care for dying patients-German legislation. Intensive Care Med. 2007. 33:1823–1826.

6. Code de la sante publiqué. Loi n° 2005-370, J.O. 23 avril 2005. Euthanasia and assisted suicide: International Experiences. Marlisa Tiedemann Dominique Valiquet Law and Government Division Revised 17 July 2008. 2009. Accessed at 26.July. Parliamentary Information and Research Service; http://dsppsd.pwgsc.gc.ca/collection_2008/lop-bdp/prb/prb07031e.pdf.